Why is obesity associated with osteoarthritis? Insights from mouse models of obesity

Obesity is one of the most significant, and potentially most preventable, risk factors for the development of osteoarthritis, and numerous studies have shown a strong association between body mass index and osteoarthritis of the hip, knee, foot and hand. However, the mechanism(s) by which obesity contributes to the onset and progression of osteoarthritis are not fully understood. The strong association between body mass index, altered limb alignment, and osteoarthritis of the knee--and the protective effects of weight loss--support the classic hypothesis that the effects of obesity on the joint are due to increased biomechanical loading and associated alterations in gait. However, obesity is now considered to be a low-grade systemic inflammatory disease, and recent studies suggest that metabolic factors associated with obesity alter systemic levels of pro-inflammatory cytokines that are also associated with osteoarthritis. Thus, the ultimate influence of obesity on osteoarthritis may involve a complex interaction of genetic, metabolic, and biomechanical factors. In this respect, mouse models of obesity can provide excellent systems in which to examine causal relationships among these factors. In recent years, there have been surprisingly few reports examining the effects of obesity on osteoarthritis using mouse models. In this paper, we review studies on mice and other animal models that provide both direct and indirect evidence on the role of obesity and altered diet in the development of osteoarthritis. We also examine the use of different body mass indices for characterizing "obesity" in mice by comparing these indices to typical adiposity levels observed in obese humans. Taken together, evidence from studies using mice suggest that a complex interaction of environmental and genetic factors associated with obesity contribute to the incidence and severity of osteoarthritis. The ability to control these factors, together with the development of methods to conduct more intricate measures of local biomechanical factors, make mouse models an excellent system to study obesity and osteoarthritis.     

Does adipocyte hypercellularity in obesity exist?

Adipose tissue samples were biopsied from three subcutaneous sites in 80 obese and 27 non-obese patients. Additional samples were taken from intra-abdominal sites in 44 of the patients. There was a small increase in the calculated number of fat cells in the more obese patients, but there was no relation between fat-cell number and obesity of childhood onset. Omental fat cells were one-third the size of subcutaneous cells. Thus the calculated number of fat cells, usually based solely on subcutaneous samples, is an underestimate of the true number, and most obese patients can accommodate their fat without needing to recruit new cells. The diagnosis of "hyperplastic" obesity--that is, an excess number of fat cells--is unreliable and its relation to infantile obesity doubtful.     

Will fatty worms help cure human obesity?

The incidence of obesity has reached epidemic proportions within industrial societies; however, research on human obesity has been hampered by our inability to control genetic and environmental factors. The control of energy homeostasis appears to be conserved among species. Recent creative research in Caenorhabditis elegans, including the application of a genome-wide RNA interference analysis, has provided insight into the genes involved in energy balance. In this article, we discuss the results of these studies and their potential importance to humans.     

TNF-α system and lung function impairment in obesity

A potential interaction between pulmonary function, abnormal adipose tissue activity, and systemic inflammation has been suggested. This study explores the relationship between circulating soluble TNF-α receptors (sTNF-R1 and sTNF-R2) and respiratory function parameters in obese subjects. Thirty-one non-diabetic morbidly obese women with a history of non-smoking and without prior cardiovascular or respiratory disease were prospectively recruited in the outpatient Obesity Unit of a referral center. Pulmonary function test included a forced spirometry, static pulmonary volume measurements, non-attended respiratory polygraphy, and arterial gas blood sampling. Circulating levels of sTNFR-R1, sTNF-R2, interleukine 6 and adiponectin were determined using ELISA. Statistical analysis included a multivariate regression analysis taking into account the potential confounders. sTNF-R1 positively correlated with BMI (r=0.571, p=0.001) and arterial carbon dioxide pressure (PaCO(2), r=0.381, p=0.038), but negatively with forced expiratory volume in 1s (FEV(1), r=-0.437, p=0.012), maximum midexpiratory flow (FEF(25-75), r=-0.370, p=0.040) and forced vital capacity (FVC, r=-0.483, p=0.005). However, no correlation between sTNF-R2 and BMI and either pulmonary function tests or arterial blood samples was observed. Multiple linear regression analysis showed that sTNF-R1 independently predicted FEV(1) (beta=-0.437, p=0.012) and FVC (beta=-0.483, p=0.005). Thus, circulating levels of sTNF-R1, but not sTNF-R2, are related to reduced lung volumes and airflow limitation in morbidly obese patients prior to the development of a clinically recognized respiratory disease. Therefore, studies addressed to evaluating the potential beneficial effect of anti-TNF-α agents on pulmonary function tests in obese subjects seem warranted.     

Tumour necrosis factor, a key role in obesity?

Tumour necrosis factor-alpha (TNF) is a pleiotropic cytokine involved in many metabolic responses in both normal and pathophysiological states. In spite of the fact that this cytokine (also known as "cachectin") has been related to many of the metabolic abnormalities associated with cachexia, recent studies suggest that TNF may also have a central role in obesity modulating energy expenditure, fat deposition and insulin resistance. This review deals with the role of TNF in the control of fat mass and obesity.     

Does smoking affect body weight and obesity in China?

An inverse relationship between smoking and body weight has been documented in the medical literature, but the effect of cigarette smoking on obesity remains inconclusive. In addition, the evidence is mixed on whether rising obesity rates are an unintended consequence of successful anti-smoking policies. This study re-examines these relationships using data from China, the largest consumer and manufacturer of tobacco in the world that is also experiencing a steady rise in obesity rates. We focus on the impact of the total number of cigarettes smoked per day on individuals’ body mass index (BMI) and on the likelihood of being overweight and obese. Instrumental variables estimation is used to correct for the endogeneity of cigarette smoking. We find a moderate negative and significant relationship between cigarette smoking and BMI. Smoking is also negatively related to being overweight and obese, but the marginal effects are small and statistically insignificant for being obese. Quantile regression analyses reveal that the association between smoking and BMI is quite weak among subjects whose BMIs are at the high end of the distribution but are considerably stronger among subjects in the healthy weight range. Ordered probit regression analyses also confirm these findings. Our results thus reconcile an inverse average effect of smoking on body weight with the absence of any significant effect on obesity. From a policy perspective these findings suggest that, while smoking cessation may lead to moderate weight gain among subjects of healthy weight, the effects on obese subjects are modest and should not be expected to lead to a large increase in obesity prevalence rates.     

Regulatory T cells expressing PPAR-γ control inflammation in obesity

A recent study (Cipolletta et al., 2012) shows that regulatory T (Treg) cells expressing the peroxisome-proliferator- activated receptor (PPAR-γ) are engaged in suppressing adipose tissue inflammation in obesity, suggesting that Treg cells may be a target for treatment and prevention of adipose tissue inflammation and insulin resistance.     

Muscle development and obesity: Is there a relationship?

The formation of skeletal muscle from the epithelial somites involves a series of events triggered by temporally and spatially discrete signals resulting in the generation of muscle fibers which vary in their contractile and metabolic nature. The fiber type composition of muscles varies between individuals and it has now been found that there are differences in fiber type proportions between lean and obese animals and humans. Amongst the possible causes of obesity, it has been suggested that inappropriate prenatal environments may ‘program’ the fetus and may lead to increased risks for disease in adult life. The characteristics of muscle are both heritable and plastic, giving the tissue some ability to adapt to signals and stimuli both pre and postnatally. Given that muscle is a site of fatty acid oxidation and carbohydrate metabolism and that its development can be changed by prenatal events, it is interesting to examine the possible relationship between muscle development and the risk of obesity.Key words: myogenesis, myogenic regulatory factors, FOXO, PGC-1α, PPAR undernutrition, muscle fibre type specification, obesity, fetal, growth     

Is genetically transmitted obesity due to an adipose tissue defect?

1. The aim of this investigation was to ascertain of a variety of obese rodents whether the primary cause of fat cell enlargement lay in the fat cell itself, or in its environment. Rodents studied were the mutant mice 'diabetic' (db/db), 'adipose' (dbad/dbad), and 'yellow obese' (Ay/+), New Zealand obese mice, CBA mice made obese with gold thioglucose, and obese BIO 4.24 hamsters. 2. Gonadal fat of obese or lean genotype was transplanted under the kidney capsule of an obese or lean host. Grafts were left in place for at least one month, then examined histologically to measure fat cell diameters, from which fat cell masses were calculated. 3. Immunological rejection of grafts was avoided either by using mice syngeneic except for the obesity producing mutation (db/db, dbad/dbad or Ay/+) or by transplanting into F1 hybrids (NZO X BALB/c) made by mating the strains acting as donors of obese or lean fat. Transplantation of fat between lean BIO 4.22 hamsters and obese BIO 4.24 hamsters was possible because these had common histocompatibility antigens. 4. In all the forms of murine obesity studied, 'lean' fat cells enlarged in an obese recipient to the size typical of cells in 'obese' fat whilst 'obese' fat cells shrunk in a lean recipient to, at least, the size typical of 'lean' fat. Lean hamster fat cells also enlarged in an 'obese' environment and 'obese' hamster cells shrunk in a 'lean' environment. 5. Environment therefore contributes to the determination of fat cell size in all the rodents studied, and in several rodents (db/db, dbad/dbad, Ay/+, and gold thioglucose obese mice) our results showed that environmental factors are of paramount importance in determining cell size, and factors associated with the fat cell itself make a negligible contribution.     

Estrogens and obesity: is it all in our heads?

Estrogens have preventative effects on weight gain and associated comorbidities, but the tissue-specific targets remain unknown. Here, Xu et al. (2011) demonstrate that ablation of estrogen signaling in two populations of hypothalamic neurons leads to weight gain and subsequent metabolic dysregulation and could be important target sites of estrogen actions.     

Treating obesity: does antagonism of NPY fit the bill?

In this issue of Cell Metabolism, Erondu et al., (2006) identify a selective neuropeptide Y5 receptor antagonist that, as predicted from rodent studies, results in weight loss when administered to overweight and obese human subjects. In a one-year randomized placebo-controlled clinical trial, the weight loss was modest; the results support the emerging concept that NPY acts via overlapping and redundant energy homeostasis pathways.     

Interacting epidemics? Sleep curtailment, insulin resistance, and obesity

In the last 50 years, the average self-reported sleep duration in the United States has decreased by 1.5-2 hours in parallel with an increasing prevalence of obesity and diabetes. Epidemiological studies and meta-analyses report a strong relationship between short or disturbed sleep, obesity, and abnormalities in glucose metabolism. This relationship is likely to be bidirectional and causal in nature, but many aspects remain to be elucidated. Sleep and the internal circadian clock influence a host of endocrine parameters. Sleep curtailment in humans alters multiple metabolic pathways, leading to more insulin resistance, possibly decreased energy expenditure, increased appetite, and immunological changes. On the other hand, psychological, endocrine, and anatomical abnormalities in individuals with obesity and/or diabetes can interfere with sleep duration and quality, thus creating a vicious cycle. In this review, we address mechanisms linking sleep with metabolism, highlight the need for studies conducted in real-life settings, and explore therapeutic interventions to improve sleep, with a potential beneficial effect on obesity and its comorbidities.